Abstract
New York City was hit hard by the COVID-19 pandemic. Although the immediate health burden was devastating, we posit that its long-term impact will be even greater, because the rapid spread of COVID-19 both depended on and exacerbated other deep-seated inequities related to food and broader living conditions. Using the Bronx as a case study, we explore the intersection of the pandemic with two other persistent problems: food insecurity and diet-related diseases, a constellation we label the COVID-Food Syndemic. Syndemic theory focuses on the common causes and biological and social interactions between two or more health problems. We hypothesize that with its focus on the common social causes of ill health, this approach can inform and strengthen the synergies between community-based, activist-driven solutions and municipal government responses, thus reducing the burden of ill health in the Bronx. We suggest that combining these two approaches can more fully mobilize the social changes that are needed in the food system and beyond to interrupt the fundamental drivers of this syndemic and capitalize on the respective strengths of government, civil society, and activists.
Highlights
In March 2020, the novel coronavirus SARS-CoV2 began its devastating spread in New York City
We explore the intersection of the COVID-19 pandemic with two other persistent problems: high rates of food insecurity and diet-related diseases (DRD)
Centering our inquiry in the Bronx, we examine in what ways the concept of syndemic, defined as “two or more epidemics ... interacting synergistically and contributing, as a result of their interaction, to excess burden of diseases in a population” (Singer & Clair, 2003), can lead to more effective public health programs and public policies to reduce the burden of disease that this syndemic we call the COVID-Food Syndemic—food insecurity, DRD, and COVID-19—imposes on the people of the Bronx
Summary
In March 2020, the novel coronavirus SARS-CoV2 began its devastating spread in New York City. They offer programs and services related to all three outcomes of the syndemic (food insecurity, DRD, and COVID-19) and assist their constituencies in addressing the intersecting impact of the three conditions, for example by preventing evictions, finding healthy affordable food, and enrolling in comprehensive primary care. By mobilizing community residents and relying on their experience in addressing deep-seated community problems, these organizations tap into the human capital that is the most valuable resource of low-income urban communities While these groups have not explicitly articulated a syndemic perspective, their actions demonstrate an understanding of shared fundamental causes, the reality of the intersecting manifestation of food insecurity, DRD, and COVID-19 in the lived experience of many Bronx residents, and the power of a comprehensive and collective social justice approach to improving health. By supporting, nurturing, and leveraging this energy and passion, and by finding ways to align its power with the capacity of public officials, public agencies, and local businesses willing to work for a healthier and more equitable Bronx, New York City, and nation, health professionals and community advocates can contribute to reversing the multifaceted syndemic that threatens the future of the Bronx and urban America
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